Many nursing home residents suffer from cognitive impairment and are unable to communicate symptoms such as pain or anxiety. This gap in communication complicates effective care, as symptom data often does not appear in electronic health records (EHRs).
A recent study focuses on adapting a widely-used symptom assessment tool to help capture this critical data, aiming to improve palliative care services for nursing home residents.
The study, part of the UPLIFT-AD initiative (Utilizing Palliative Leaders in Facilities to Transform care for people with Alzheimer’s Disease), involved researchers from the Regenstrief Institute, Indiana University School of Medicine, and the University of Maryland School of Social Work.
The UPLIFT-AD team modified a tool originally designed for reporting by family members after a dementia patient’s death. The modified tool now enables nursing home staff and families to report symptoms for residents with moderate to severe dementia.
Dr. Kathleen T. Unroe, M.D., MHA, M.S., and Dr. John G. Cagle, PhD, led the team in validating the tool, which assesses physical and emotional distress, as well as well-being and symptoms indicative of end-of-life stages.
This new approach helps fill the gap in symptom recognition and management for nursing home residents, particularly those with cognitive impairments, allowing for more timely and accurate interventions.
The team hopes the UPLIFT-AD trial will provide a model for expanding palliative care in nursing homes, offering practical tools for improving symptom management for cognitively impaired individuals.
Dr. Unroe emphasized the challenges of capturing reliable symptom data in nursing homes, where many residents have multiple chronic conditions and limited ability to communicate their needs.
Incorporating this enhanced tool into clinical practice aims to make symptom assessment more consistent and frequent, improving the quality of care for nursing home residents, especially those with dementia.
The UPLIFT-AD initiative is expected to offer crucial guidance for expanding palliative care services and hopes to serve as a replicable model for nursing homes across the country by 2026.
